MEDICARE: OHANA HOME HEALTH AND HOSPICE SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	251G00000X	Community Based Hospice Care Agency
3	253Z00000X	In Home Supportive Care Agency
4	163WH0200X	Home Health Registered Nurse

General Provider Information

NPI Number	:	1386253425
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHANA HOME HEALTH AND HOSPICE SERVICES

Provider Business Mailing Address
First Line	:	1229 E PLEASANT RUN RD STE 208
Second Line	:
City	:	DESOTO
State	:	TX
Zip	:	75115-4214
Country	:	US
Telephone Number	:	972-672-4236
Fax Number	:

Provider Business Practice Location Address
First Line	:	1229 E PLEASANT RUN RD STE 208
Second Line	:
City	:	DESOTO
State	:	TX
Zip	:	75115-4214
Country	:	US
Telephone Number	:	972-672-4236
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ESTAVION TROTTER
Credential	:
Telephone Number	:	972-672-4236

Provider Enumeration Date	:	07/24/2020
Last Update Date	:	07/24/2020

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Directions to “OHANA HOME HEALTH AND HOSPICE SERVICES ” Practice Location

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